Risk factors for postoperative recurrence in Korean patients with Crohn’s diseaseopen access
- Authors
- Kim, Sung Bae; Cheon, Jae Hee; Park, Jae Jun; Kim, Eun Soo; Jeon, Seong Woo; Jung, Sung-Ae; Park, Dong Il; Lee, Chang Kyun; Im, Jong Pil; Kim, You Sun; Kim, Hyun Soo; Lee, Jun; Eun, Chang Soo; Lee, Jeong Mi; Jang, Byung Ik; Seo, Geom Seog
- Issue Date
- May-2020
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Crohn disease; Recurrence; Risk factors; Surgery; Thiopurine
- Citation
- GUT AND LIVER, v.14, no.3, pp.331 - 337
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- GUT AND LIVER
- Volume
- 14
- Number
- 3
- Start Page
- 331
- End Page
- 337
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/9814
- DOI
- 10.5009/gnl19085
- ISSN
- 1976-2283
- Abstract
- Background/Aims: A considerable number of patients with Crohn’s disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn’s disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients.
Methods: Clinical data of 372 patients with Crohn’s disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed.
Results: Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR, 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence.
Conclusions: Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence.
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